Fishel S B, Webster J, Faratian B, Jackson P, Shelton K, Johnson J
Department of Obstetrics and Gynaecology, University Hospital, Queen's Medical Centre, Nottingham, UK.
Hum Reprod. 1991 Jan;6(1):106-12. doi: 10.1093/oxfordjournals.humrep.a137242.
Data are presented on establishing pregnancies by IVF during 1987 using only clomiphene citrate and human menopausal gonadotrophin for follicular stimulation. Of the 562 patients undergoing follicular stimulation, 80% reached oocyte recovery and 70% had at least one conceptus replaced. Patients having one or more (up to a maximum of four) conceptuses replaced demonstrated a significant increase in the establishment of pregnancies from one to two (14-29%: P = 0.035) and from two to three conceptuses (29-42%: P = 0.037). There was a significant decline in pregnancies when four conceptuses were replaced compared with three (P = 0.004). The data were also analysed according to the cause of infertility, specifically tubal, endometriosis, unexplained infertility and male factors only. After the replacement of conceptuses, the incidence of implantation and abortion was not significantly different. The incidence of pregnancy declined significantly after 35 years (26%) compared with women under 31 years (43%; P = 0.043). Of 129 women having three conceptuses replaced, in those greater than 35 years (63 patients) 23 (37%) became pregnant whereas in those less than 31 years (65 patients), 34 (52%; P = 0.05) became pregnant. Twenty-two per cent of stimulated cycles resulted in an endogenous LH surge and the incidence of patients having three conceptuses replaced in this group was lower than those in the HCG group (P = 0.007). Fertilization per oocyte was also significantly reduced (P less than 0.001) in patients with an LH surge. In total, 2824 oocytes were recovered and 57% fertilized with 54% of patients having three conceptuses replaced.(ABSTRACT TRUNCATED AT 250 WORDS)
本文呈现了1987年使用枸橼酸氯米芬和人绝经期促性腺激素进行卵泡刺激通过体外受精（IVF）建立妊娠的相关数据。在562例接受卵泡刺激的患者中，80%成功获取了卵母细胞，70%至少移植了一个孕体。移植一个或多个（最多四个）孕体的患者，妊娠建立率从一个孕体增加到两个时有显著升高（14% - 29%：P = 0.035），从两个孕体增加到三个孕体时也有显著升高（29% - 42%：P = 0.037）。与移植三个孕体相比，移植四个孕体时妊娠率显著下降（P = 0.004）。数据还根据不孕原因进行了分析，具体为输卵管性、子宫内膜异位症、不明原因不孕以及仅男性因素。移植孕体后，着床率和流产率无显著差异。35岁及以上女性的妊娠率（26%）与31岁以下女性（43%；P = 0.043）相比显著下降。在129例移植三个孕体的女性中，35岁及以上（63例患者）有23例（37%）妊娠，而31岁以下（65例患者）有34例（52%；P = 0.05）妊娠。22%的刺激周期出现内源性促黄体生成素（LH）峰，该组中移植三个孕体的患者发生率低于人绒毛膜促性腺激素（HCG）组（P = 0.007）。出现LH峰的患者每个卵母细胞的受精率也显著降低（P < 0.001）。总共获取了2824个卵母细胞，57%受精，54%的患者移植了三个孕体。（摘要截选至250词）
